Lung cancer is one of the most common and deadly forms of cancer diagnosed worldwide. According to global cancer statistics, lung cancer is the leading cause of cancer-related deaths across the globe. Surgical removal of cancerous tissues remains one of the most effective treatment options for lung cancer depending on the stage and type of cancer. Let's take a closer look at lung cancer surgery.

Types of Lung Cancer Surgery

There are different types of lung cancer surgeries performed depending on the location and size of the cancerous tumor in the lungs. Some of the common types include:

Wedge resection: This involves removing a small wedge-shaped section of the lung containing the tumor. It is usually done for small tumors located in the outer parts of the lungs.

Lobectomy: During a lobectomy, the surgeon removes an entire lobe of the lung. The right lung has three lobes and the left lung has two lobes. This surgery is more invasive than a wedge resection but allows for clear margins around the tumor.

Pneumonectomy: For large central tumors, the surgeon may have to remove an entire lung during a pneumonectomy. This major surgery reduces lung function significantly and is only considered for large lung cancers confined to one lung.

Sleeve resection: In this procedure, the surgeon removes the cancerous portion of the lung along with some surrounding tissues but leaves most of the lung intact. It aims to preserve more lung function.

Factors Determining Resectability

Not all lung cancer patients are candidates for surgery. Some key factors that determine if a tumor can be safely removed through surgery include:

- Size, location and invasive extent of the primary tumor
- Whether the cancer has spread to lymph nodes or other organs
- Patient's overall health and cardiopulmonary function
- Ability to achieve clear surgical margins around the tumor

Multidisciplinary Approach

Today, lung cancer surgery follows a multidisciplinary approach involving medical oncologists, radiation oncologists, pulmonologists, pathologists and imaging specialists. Together they thoroughly stage and evaluate each case to determine resectability.

In some cases, chemotherapy or radiation therapy may be given before surgery to shrink large tumors and make them resectable. Positron emission tomography (PET) scans help surgeons accurately map the extent of disease pre-operatively.

Surgical Techniques and Outcomes

Over the last couple of decades, surgical techniques and technologies for lung cancer have vastly improved. The use of video-assisted thoracic surgery (VATS) has reduced post-operative pain, recovery time and complications compared to traditional open surgery.

With proper patient selection, advanced surgical techniques and multidisciplinary care, lung cancer surgery can provide good outcomes. For early-stage non-small cell lung cancers (NSCLC), surgical resection offers 5-year survival rates over 70%. Even some stage IIIA NSCLC patients can experience long-term survival after combined surgery and adjuvant chemotherapy or radiation.

Risks and Complications

As with any major surgery, lung cancer operations carry certain risks, depending on the procedure. Risks may include bleeding, infection, prolonged air leaks, pneumonia and cardiac issues. Missing cancerous cells around the edges of resection (positive margins) is another potential risk.

Most complications are managed well with proper post-operative care and follow-up. Some patients may also experience reduced lung capacity after surgical removal of part of their lung. Early mobilization, pulmonary rehabilitation exercises and smoking cessation can help optimize lung function recovery.

The Role of Surgery in Combined Modality Treatment

For early-stage non-small cell lung cancer (NSCLC), surgery remains the mainstay of curative treatment. However, for more advanced stages, multimodal therapy combining surgery, chemotherapy and/or radiation therapy offers the best chance of cure.

For example, in stage IIIA NSCLC where cancer has spread to nearby lymph nodes, research shows combining surgery with adjuvant chemotherapy or radiation therapy improves overall survival compared to any single modality alone. Even for limited stage small cell lung cancer (SCLC), combining surgery with chemotherapy and/or radiation can provide improved survival benefits.

Overall, advancements in surgical techniques, technologies and integration with other modalities have made lung cancer surgery a safe and viable option for many patients to potentially cure their disease or prolong survival. When performed by experienced thoracic surgeons at high-volume centers, lung cancer resection offers promising outcomes. Combined with other treatment approaches, it plays a vital role in optimizing outcomes for various stages of lung malignancies.

Get more insights on- Lung Cancer Surgery